NDLI: Using a single screening question for depressive symptoms in patients with acute coronary syndrome.

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Using a single screening question for depressive symptoms in patients with acute coronary syndrome.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Frazier, Lorraine Sanner, Jennifer Yu, Erica Cron, Stanley G. Moeller, F. Gerard
Description	Author Affiliation: Frazier L ( Lorraine Frazier, PhD, RN, MS, FAHA, FAAN Dean and Professor, College of Nursing, University of Arkansas for Medical Sciences, Little Rock. Jennifer Sanner, PhD, RN Assistant Professor, School of Nursing, Department of Nursing Systems, The University of Texas Health Science Center at Houston. Erica Yu, PhD, RN, ANP Assistant Professor, School of Nursing, Department of Acute & Continuing Care, The University of Texas Health Science Center at Houston. Stanley G. Cron, MSPH Research Instructor, School of Nursing, Center for Nursing Research, The University of Texas Health Science Center at Houston. F. Gerard Moeller, MD Professor of Psychiatry and Director, Center for Neurobehavioral Research on Addictions, The University of Texas Health Science Center at Houston.)
Abstract	BACKGROUND: Despite the prevalence of depressive symptoms and increased risk for future cardiovascular events, depressive symptoms frequently go underrecognized in patients hospitalized for acute coronary syndrome (ACS). Identifying an effective approach to depressive symptom screening is imperative in this population. OBJECTIVE: The purpose of this cross-sectional study was to explore the agreement between Beck Depression Inventory-II (BDI-II) scores and a single screening question for depressive symptoms in 1122 patients hospitalized for ACS. METHODS: Independent-samples t tests and χ tests were used to compare the groups with BDI-II scores of 14 or higher and lower than 14. Three separate agreement analyses were conducted using categorized BDI-II scores (≥14, ≥20, and ≥29). Agreement of the BDI-II categories with the responses to the single screening question was assessed with the simple κ statistic. Sensitivity and specificity were calculated using the BDI-II categories as the criterion standards for depressive symptom screening. RESULTS: The agreement analysis revealed a moderate level of agreement (κ coefficient = 0.42) between the BDI-II scores of 14 or higher and the single screening question. Of the participants who reported a BDI-II score of 14 or higher, 61.65% answered yes to the single screening question (sensitivity, 0.62). For those who had BDI-II scores of lower than 14, a total of 82% responded no to the single screening question (specificity, 0.82). When using higher BDI-II scores to define depressive symptoms (≥20 and ≥29), the level of agreement decreased, whereas sensitivity increased to 0.76 and 0.90, with a trade-off in specificity (0.79 and 0.74, respectively). CONCLUSIONS: These results suggest that the single screening question for depressive symptoms correctly identifies depressive symptoms 62% of the time but inappropriately identifies depressive symptoms 18% of the time in patients hospitalized for ACS. This suggests that the single screening question for depressive symptoms may be used with caution to initially screen patients with ACS, who can then undergo a more thorough assessment for clinical depression.
File Format	HTM / HTML
ISSN	08894655
e-ISSN	15505049
DOI	10.1097/JCN.0b013e318291ee16
Journal	The Journal of Cardiovascular Nursing
Issue Number	4
Volume Number	29
Language	English
Publisher	Lippincott Williams & Wilkins
Publisher Date	2014-07-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Cardiology Acute Coronary Syndrome Epidemiology Depression Diagnosis Mass Screening Self Report Severity Of Illness Index Psychology Comorbidity Cross-sectional Studies Health Behavior Psychiatric Status Rating Scales Questionnaires Research Support, N.i.h., Extramural
Content Type	Text
Resource Type	Article
Subject	Advanced and Specialized Nursing Cardiology and Cardiovascular Medicine

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